CF 216: Return To Play After Herniation & Water vs. PT Exercises Today we’re going to talk about return To Play After Herniation & Water vs. PT Exercises But first, here’s that sweet sweet bumper music

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

<figure class="aligncenter"></figure>

<figure class="aligncenter"></figure>

<figure class="aligncenter"></figure>

<figure class="aligncenter"></figure>

<figure class="aligncenter"></figure>

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 

• Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s a great resource for patient education and for YOU. It saves you time in putting talks together or just staying current on research. It’s categorized into sections and written in a way that is easy to understand for you and patients. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 


• Then go Like our Facebook page, 


• Join our private Facebook group, and then 


• Review our podcast on whatever platform you’re listening to 


• Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #216 Now if you missed last week’s episode , we talked about the MCM Mastermind that I am a member of & we talked about CAM Acceptance Among Medical Specialists. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

I’m still settling back in after that Florida mastermind that we talked about last week. Still getting my mind wrapped around the information and the best ways to implement the ideas.  One of my biggest obstacles to practice has been good, evidence-based, patient-centered guidelines for dosing. Meaning, how many times should a patient be seen? Well, one of the mastermind members is Dr. Jay Greenstein. If you don’t know him, I suggest you get that remedied muy pronto mi amigo.  Jay has done a lot of work with Clinical Compass and based on research in the Journal of Manipulative and PHhysiologica Therapies and based on Haas’s research in Spine, Dr. Greenstein has been kind enough to guide me along. 

Here’s a lesson for me and for listeners. As far along as you are, whether in the beginning, in middle, or toward the end, you can always learn. Now, instead of saying 3x/week for a couple of weeks, and then we’ll see where you’re at….instead of that, I have firm, research-based, Clinical Compass-approved recommendations for what I tell them. 

My biggest gap is patient stick-to-it-iveness. I may see 80 new patients a month but still only see 650 visits that month. Because my new patients don’t typically make it to the first re-exam.  It’s not like I don’t know this problem. It’s always been an issue. Some of us have money issues. We do the stuff to make more money but we’re not always sure we deserve more money or deserve to live well, blah blah blah. That’s the mental health aspect of dealing with money. 

I turned financial talks over to the staff because I’m not good with money discussions when it comes to people paying me. I’m fine when I’m talking about stuff I’m doing to try to make money. I’m not good when we’re talking about me making money from someone. It’s just what it is.  Here’s the thing though, if I know it’s backed and supported and even encouraged as far as guidelines, then it’s on. I have no problem with making the recommendations and making them stronger.  So, there you are. Once my recommendations are better, my income improves immediately. This means I can easily training those under me and comfortably hire more providers, etc.

All from one thing; more effective communication with my new patients from the get-go. 

Also, I’m reading the book Traction: Get a Grip on Your Business by Gino Wickman. This was recommended by several in the MCM Mastermind so I’m already in Chapter 6 on this sucker and wondering why I didn’t read it years ago. It’s there to help identify issues, communicate more effectively with your team, and get the right people in the right seats.  What are you working on professionally this week? Email me at dr.williams@chiropracticforward.com.

I’d love to hear it. 

Let’s hop in Item #1

The first one today is called “Return to Play After Symptomatic Lumbar Disc Herniation in Elite Athletes: A Systematic Review and Meta-analysis of Operative Versus Nonoperative Treatment” by Sedrak, et. al. (Sedrak 2021) and published in Sports Health on Feb 10 of 2021 and only a year old is still significantly steamy. 

Why They Did It

The prevalence of symptomatic lumbar disc herniation (LDH) in athletes can be as high as 75%. For elite athletes diagnosed with LDH, return to play (RTP) is a major concern, and thus comparing surgical with nonoperative care is essential to guide practitioners and athletes, not just in terms of recovery rates but also the speed of recovery. The purpose of this systematic review is to provide an update on RTP outcomes for elite athletes after lumbar discectomy versus nonoperative treatment of lumbar disc herniations.

How They Did It

• Systematic review and meta-analysis


• A search of the literature was conducted using 3 online databases (MEDLINE, EMBASE, and PubMed) to identify pertinent studies.

What They Found

• Twenty studies met the inclusion criteria and were included in this review. 


• Overall, 663 out of 799 patients (83.0%) returned to play in the surgical group and 


• 251 out of 308 patients (81.5%) returned to play in the nonoperative group. 


• No statistically significan